Improving Care By Making Time for Physician-Patient Interaction

I have 12 grandchildren, ranging in ages from 1 to 13 years. When they visit, I sometimes get distracted by my iPhone and, let’s say, I pay them less than my complete attention. The older ones are quick to tell me that they are not getting the attention they desire—usually, by just repeating “Pappy, Pappy, Pappy, Pappy.” They want me to look at them when they are talking to me!

And, is it any different with adults when we are seeing our physicians?

Knowing this is a common complaint among patients, the last time I went to see my primary care doctor, I consciously tried to track the amount of time he actually spent looking at me. It was pretty abysmal. He did spend a LOT of time looking at the screen of his electronic medical record (EMR). Maybe I am a bit old-fashioned, but I really would like to have my physician actually look at me! It was really kind of unnerving.

I also left thinking that the overall interaction was less than satisfying.

Physicians likewise hate how the EMR is destroying their ability to look at their patients and see their facial expressions when they are talking. When I was practicing as a family physician, how many times did I “see” the story behind the chief complaint—just by observing the patient?

This constant attention to the ever-increasing demands of the EMR is not only destroying patient-physician communication, it is also making physicians less productive; alternatively, they have to spend hours at night finishing up their documentation in order to fulfill health plan and government requirements.

For this reason, many physicians are now employing scribes. In fact, an article in Physicians Practice noted that more than 1 in 5 physicians now use a scribe. However, having an on-site scribe is fraught with plenty of personnel issues.

A small company located in Westminster, Colorado, called SkywriterMD may have an answer for both problems. They provide an affordable, virtual team of scribes who are dedicated to each practice and available at any time.

Skywriter MD’s virtual scribes, referred to as “skywriters,” serve as an extension of a physician throughout the patient visit. Physicians—or any other provider for that matter—can access Skywriter MD by logging into a HIPPA-compliant website using a desktop, laptop, or tablet. The user interface supports direct and indirect interaction throughout the patient visit, while the non-intrusive presence of the Skywriter enables a more personable patient–physician encounter.

Skywriters, who are certified through the American College of Medical Scribe Specialists, help providers to navigate the EMR, enter data, and execute other tasks as directed verbally by the physician.

Benefits include:

• Increased time spent addressing patient needs and actually communicating with them;
• The ability to leverage the physician employees more efficiently;
• The ability to see more patients each day, thus increased revenue; and
• Maximized EMR use and ability to meet meaningful use requirements, while still improving internal efficiencies.

Skywriter MD is the brainchild of Tracy Rue, CEO and Founder, whose background in EMR implementation and adoption allowed him to witness first-hand the documentation burden that was placed on the physician with the advent of EMRs.

Using a secure web-based approach, his company has designed a way for each provider to be supported by a team of Skywriters who, over time, develop a personal relationship with the provider and understand his/her workflow, templates and preferences. They listen in on the visit. A “mute” button is used to open and suspend the audio feed. Providers can review the actions of the Skywriter in real time, or they may evaluate and cosign documentation at the conclusion of the visit. All Skywriter documentation and actions within the EMR are conducted using the Skywriter’s individual login credentials. One click closes the screen-share and the secure connection.

The company states that skywriters are able to anticipate the needs of the physicians they support.

Maybe, next time I see a physician, he will actually see me!